The Texas Medical Association, the state's largest physician society representing more than 60,000 doctors, says it has joined a sweeping federal antitrust lawsuit accusing Claritev, the company formerly known as MultiPlan, and several major insurers of coordinating to suppress out-of-network reimbursements. Plaintiffs argue the alleged scheme has drained billions from providers and is putting independent practices across Texas on the ropes.
In a news release from the Texas Medical Association, the group said it has signed on to multidistrict litigation that names Claritev along with insurers UnitedHealth, Elevance, Humana, Aetna and Cigna. The move was also covered by the Houston Business Journal.
How Doctors Say The System Got Rigged
Provider plaintiffs contend Claritev acted as a central hub for insurers' pricing decisions, relying on proprietary repricing tools and shared data to recommend below-market payments for out-of-network claims. The company rebranded from MultiPlan in 2025, according to filings with the SEC.
Industry reporting and court filings put the alleged financial hit in stark terms: roughly $19 billion in underpayments in 2020 and about $6.4 billion in one quarter of 2024. Those figures have been highlighted by FierceHealthcare and discussed by plaintiffs' counsel at Seeger Weiss.
Why Texas Doctors Are Jumping In
"For many years, physicians in Texas have been forced to accept increasingly insufficient reimbursements for providing health care to out-of-network patients," TMA President Jayesh "Jay" Shah, M.D., said in the association's statement. TMA, which represents more than 60,000 physicians statewide, says the suit aims to claw back historic underpayments and protect independent practices that plaintiffs warn are at risk of cutting services or shutting down altogether, concerns that have also been raised by the American Medical Association.
Where The Massive Case Stands Now
The suits have been centralized as MDL No. 3121 in the U.S. District Court for the Northern District of Illinois, and the Department of Justice filed a statement of interest in March 2025 backing aspects of the providers' theory, according to reporting by Healthcare Dive. A federal judge largely denied defendants' motions to dismiss in mid-2025, allowing antitrust and consumer-protection claims to move into discovery, as reported by FierceHealthcare.
Court updates indicate bellwether trials are being scheduled, with an initial trial date currently listed for Dec. 7, 2027, according to litigation tracking by Rafferty Domnick Cunningham & Yaffa. In other words, this fight is set to stretch on for years.
High-Stakes Legal Fallout
The complaints press federal Sherman Act antitrust counts alongside state antitrust and consumer-protection claims, and plaintiffs say they will seek damages and injunctive relief that could reshape how out-of-network rates are set. Legal observers note that successful antitrust claims can lead to trebled damages and broad industry changes, according to analysis from Rafferty Domnick Cunningham & Yaffa.
TMA says physicians who believe they were harmed can obtain a free case evaluation through court-appointed counsel and that the litigation's leadership structure is already in place. Claritev has maintained the lawsuits are without merit and said it will "vigorously defend" itself, according to reporting by Healthcare Dive and statements from plaintiffs' counsel at Seeger Weiss. No matter which side ultimately prevails, the outcome is poised to ripple far beyond Texas doctors' offices.
